Oral Squamous Cell Carcinoma
Patients with oral squamous cell carcinoma are commonly diagnosed at the advanced stage of malignancy and thus show a poor prognosis. Timely diagnosis and early treatment are very important to achieve a superior outcome. Several molecules, such as corticosteroids , glycosylation-related molecules, oxidative stress-related molecules, and inorganic molecules, have been reported to correlate with the OSCC diagnosis . HPLC and commercial colorimetric methods are among the main tools used to analyze these biomarkers, but several other techniques have been reported to date . Lee LT et al. used Luminex Bead-based Multiplex assays to discover diagnostic biomarkers in human saliva and plasma responsible for tumor progression in patients with oral squamous cell carcinoma and reported that IL-1, MIP-1, IFN-, TNF-, IL-6, IL-8, and eotaxin are plausible salivary biomarkers . Thus, the identified salivary biomarkers potentially play a valuable role as a complementary adjunct in the early detection of oral OSCC .
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Can It Be Treated
Oral SCC is a very aggressive cancer in the cat. Severe and extensive bone involvement is common. Most cats present with advanced disease, making surgical removal impossible.
Radiation and chemotherapy have been used to treat oral SCC in the cat with little success. Although these tumors may shrink initially with treatment, the tumors often regrow rapidly after treatment is completed. Most cats have enough difficulty eating at the time of diagnosis that feeding tubes may be necessary if radiation therapy is to be pursued.
Treatment Options For Oral Cavity Cancer By Stage
Treatment for oral cavity cancer is based largely on the stage of the cancer, but other factors can also be important.
Most experts agree that treatment in a clinical trial should be considered for any cancer in the head and neck area. This way, people might have the chance of getting new treatments that may be better than standard ones.
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Mouth Cancer Treatment And Prognosis
The prognosis for a cat with mouth cancer depends on the type of tumor involved and how advanced it is at the time of diagnosis.
The treatment and prognosis of oral cancer in cats is dependent on two factors: the type of tumor involved and how advanced the tumor is at the time of diagnosis.
Oral squamous cell carcinoma generally is associated with a poor prognosis, regardless of treatment. According to North Carolina State University, cats with oral squamous cell carcinoma survive an average of two to four months with treatments such as surgical removal, radiation therapy, and chemotherapy.
Less than 10% of cats with oral squamous cell carcinoma survive to one year. In general, cats in which the tumor is diagnosed and treated earlier are expected to have better outcomes than cats whose cancer is diagnosed at a later stage.
Other oral tumors, such as fibrosarcoma, osteosarcoma, and odontogenic tumors, are associated with longer anticipated survival times than squamous cell carcinoma. The first step in treating these tumors is typically surgery, which may be followed by radiation and/or chemotherapy.
In some cases, palliative radiation may be used to keep a cat comfortable and extend his or her lifespan, even if the cancer cannot be cured.
Risk Factors For Developing Mouth Cancer
Some dogs are more likely than others to develop mouth cancer. In general, male dogs and dogs with heavily pigmented gums, especially small dogs, appear to be at a higher risk of developing mouth cancer but there are also specific breeds that are more likely than others to be affected. These include the following:
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Prevention And Treatment Planning Before Cancer Therapy
Prevention of oral disease and careful treatment planning are essential to minimize oral disease and the need for, and possible adverse consequences of, operative intervention. Many adults with malignant head and neck disease often have poor oral hygiene and dental care and are poorly compliant with oral health in general. The majority of head and neck cancer patients need oral care prior to radiotherapy and/or chemotherapy for cancer. Likewise, for bone marrow transplantation. Oral care should include full-mouth radiography, baseline oral prophylaxis, extraction of any compromised tooth, ruling out of yeast infection, and instructions on proper oral hygiene. Patients should also be started on fluoride applications and should be instructed on how to minimize oral trauma and keep their mouth moist.
Extremely important, but often overlooked, is the need for psychosocial counseling patients must be counseled carefully to ensure they can adjust, at least partially, to the complications of cancer therapy.
Many patients undergoing head and neck cancer surgery, particularly of the neck, can have life-threatening postoperative complications. These can often be predicted and prevented by preoperative assessment using a specific activity scale questionnaire, an assessment of alcohol abuse, and a platelet count, because thrombocytosis identifies patients at risk for wound infection.
Living With Mouth Cancer
Having mouth cancer doesn’t necessarily mean you’ll have to give up work, but you may need quite a lot of time off, and you may not be able to carry on as you did before treatment.
If you have cancer you’re covered by the Disability Discrimination Act. This means that your employer is not allowed to discriminate against you because of your illness. They have a duty to make “reasonable adjustments” to help you cope. Examples of these include:
- allowing you time off for treatment and medical appointments
- allowing flexibility with working hours, the tasks you have to perform or your working environment
The definition of what is “reasonable” depends on the situation. For example, how much it would affect your employers business.
It will help if you give your employer as much information as possible about how much time you will need off and when. Talk to your human resources department if you have one. Your union or staff association representative should also be able to give you advice.
If you’re having difficulties with your employer, you may be able to receive help from your union or your local Citizens Advice Bureau.
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What Is The Prognosis For Oral Squamous Cell Carcinoma
The prognosis for cats with oral SCC is poor and most cats will have survival times ranging from 3 to 6 months. Cats with small tumors located on the lower jaw that are treated with surgery have a better chance of surviving for one year particularly if the mass can be completely removed.
Edited by:Christine Swanson, DVM, DACVIM April, 2020
Other Treatments For Cancer
Targeted drug therapy
Targeted drugs treat oral cancer by modifying cancer cells. Cetuximab is a targeted therapy for the treatment of head and neck cancer in certain conditions.
Cetuximab blocks the action of a protein that is found in many types of healthy cells but is prevalent in some types of cancer cells.
No complimentary or alternative medicines can cure oral cancer but can help you fight oral cancer and may also help prevent side effects of cancer treatment, such as fatigue.
Ask your doctor about appropriate exercises, massage therapy, relaxation therapy, and acupuncture.
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Palate Cheek And Other Mouth Cancers
Mouth cancer is a type of oral cancer that develops in any part of the mouth, including the lips, gums, tongue, roof of the mouth, cheeks and uvula.
According to the CDC, this is how many cancer cases were diagnosed in various parts of the mouth in 2016:
- Floor of the mouth: 1,978
- Gum: 1,727
- Cheek and other mouth: 2,463
Risk factors for these types of cancer are similar to other oral cancers and include:
- Use of tobacco products and alcohol
- Exposure to UV rays from the sun or tanning beds
Diagnosis involves a physical exam of the mouth area to look for signs of cancer and a swab to collect cells for laboratory analysis.
Diagnosis Of Oral Cancer
Following are the tests and procedures used to diagnose oral cancer:
1. Physical examination your doctor or dentist will examine your lips and mouth to check for abnormalities such as areas of irritation, sores and white patches .
2. Biopsy If a suspicious area is found, your doctor or dentist may recommend a biopsy by removing a sample of cells from the area.
3. Other tests If a biopsy confirms that you have oral cancer, you will need to have further tests to determine the stage of cancer before starting any treatment. These tests are usually done to check if cancer has spread to tissue beyond the primary cells, such as the jaw, skin, or lymph glands in your neck.
This may include the following tests:
Different types of surgery can be done in oral cancer, such as
Surgery to remove the tumor Your surgeon removes the cancerous and some of the healthy tissue around it to make sure all the cancer cells are removed.
Smaller cancers can be removed through minor surgery however if the tumor is large it may require more extensive procedures.
Surgery to remove cancer that has spread to the neck if cancer cells have spread or are prone to spread to the lymph nodes of the neck, depending on the size of your cancer, your surgeon may recommend a procedure to remove the cancerous lymph nodes. This surgery removes any cancer cells in your lymph nodes.
2. Radiation therapy
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How Squamous Cell Carcinoma Is Diagnosed
Unfortunately, clinical signs are hard to detect in the earliest of stages. Since cases of feline SCC are not easily recognizable in the beginning, tumors are typically the most obvious sign.
A fine needle aspiration can be used to diagnose tumors in many areas of the body. This procedure entails taking a small, hollow tube with suction attached and sucking up some cells from the tumor before putting them on a slide for examination under an electron microscope by veterinary pathologists.
The diagnosis process may vary depending what type of skin or nail bed pathology is observed through this method such as melanoma , sarcoma or benign neoplasia which are most common founds in dogs that express outward signs like soreness at their paw pad when being palpated
To understand whether or not your affected cat has malignant tumors indicative of SCC, it’s important that the vet orders a biopsy. By looking directly at the tumor size and taking a sample to the laboratory, the vet will be able to determine whether or not the raised bump is a malignant tumor like those in cases of oral squamous cell carcinoma in cats.
Since SCC tends to be invisible until symptoms become incredibly concerning, it doesn’t hurt to check your cat’s mouth for a tumor routinely. Though you shouldn’t let the possibility rule your mind or make you feel panicked, occasionally inspecting your cat’s mouth for a tumor is a productive and proactive measure to take.
Tobacco And Alcohol Use Can Affect The Risk Of Lip And Oral Cavity Cancer
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for lip and oral cavity cancer include the following:
- Heavy alcohol use.
- Being exposed to natural sunlight or artificial sunlight over long periods of time.
- Being male.
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What Is Advanced Scc
When a squamous cell carcinoma of the skin has spread extensively or aggressively, or has resisted multiple treatments and repeatedly recurred, it is considered to be advanced.
These tumors include:
- Locally advanced SCC: Tumors that are large or have penetrated deep into underlying tissues, muscles or nerves. These SCCs can be disfiguring and/or can compromise these underlying structures.
- Metastatic SCC: Tumors that have spread beyond the original location to other parts of the body. These SCCs can be life-threatening.
If youve been diagnosed with advanced SCC, your doctor may recommend an evaluation by a multidisciplinary team to explore treatment options. The team may include your dermatologist and/or Mohs surgeon, along with physicians and surgeons from other specialties. After surgery to remove the tumor and, if necessary due to metastasis, local lymph nodes, options may include a combination of treatments, based on the complexity of the disease and your overall health. The regimen can include:
Signs Of Lip And Oral Cavity Cancer Include A Sore Or Lump On The Lips Or In The Mouth
- A sore on the lip or in the mouth that does not heal.
- A lump or thickening on the lips or gums or in the mouth.
- A white or red patch on the gums, tongue, or lining of the mouth.
- Bleeding, pain, or numbness in the lip or mouth.
- Change in voice.
- Loose teeth or dentures that no longer fit well.
- Trouble chewing or swallowing or moving the tongue or jaw.
- Swelling of jaw.
- Sore throat or feeling that something is caught in the throat.
Lip and oral cavity cancer may not have any symptoms and is sometimes found during a regular dental exam.
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Squamous Cell Carcinoma Pictures Of The Oral Cavity
In our previous two articles, Oral pathology of Oral Cavity and Oropharyngeal Squamous Cell Carcinoma, and Oral Pathology of Oral Pharyngeal Squamous Cell Carcinoma and HPV, we looked at histological images, discussed biological profiles, trends, survival rates, and treatments. In this article we will provide additional clinical pictures of Squamous Cell Carcinoma.
Dont have time to read this article? We get it. Download the Diagnosing Vesicular Ulcerative Conditions checklist to get the key information and images from this article plus all the other conditions we cover in the Dentists Guide to Oral Pathology.
Early Signs Of Squamous Cell Mouth Cancer
Squamous cell carcinoma is the most common type of mouth cancer 2. According to 2006 information from the Merck Manual, approximately 40 percent of squamous cell growths begin on the floor of the mouth or on the tongue 40 percent develop on the lower lip and the remainder start on the roof of the mouth or the tonsils. Smoking, chewing tobacco and excessive drinking of alcohol place an individual at risk for developing mouth cancer. According to 2009 data from the Centers for Disease Control and Prevention, the five 5-year survival rate is 50 percent, but detecting the disease early improves the patient’s prognosis 1.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
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How Is Oral Cancer Diagnosed
First, your doctor or dentist will perform a physical exam. This includes closely examining the roof and floor of your mouth, the back of your throat, tongue, and cheeks, and the lymph nodes in your neck. If your doctor cannot determine why youre having your symptoms, you may be referred to an ear, nose, and throat specialist.
If your doctor finds any tumors, growths, or suspicious lesions, theyll perform a brush biopsy or a tissue biopsy. A brush biopsy is a painless test that collects cells from the tumor by brushing them onto a slide. A tissue biopsy involves removing a piece of the tissue so it can be examined under a microscope for cancerous cells.
In addition, your doctor may perform one or more of the following tests:
- X-rays to see if cancer cells have spread to the jaw, chest, or lungs
- a CT scan to reveal any tumors in your mouth, throat, neck, lungs, or elsewhere in your body
- a PET scan to determine if the cancer has traveled to lymph nodes or other organs
- a MRI scan to show a more accurate image of the head and neck, and determine the extent or stage of the cancer
- an endoscopy to examine the nasal passages, sinuses, inner throat, windpipe, and trachea
What Is Squamous Cell Carcinoma Of Oral Cavity
- Squamous Cell Carcinoma of Oral Cavity is a common malignant tumor of the mouth that typically affects elderly men and women. It is more aggressive than conventional squamous cell carcinoma affecting other body regions
- The cause of the condition is unknown, but genetic mutations may be involved. Factors that may influence its development include smoking and chewing of tobacco, radiation treatment for other reasons, and exposure to coal tar and arsenic
- The squamous cell carcinoma may appear as slow-growing skin lesions. The lesions may ulcerate and cause scarring of the oral cavity. It may be difficult to eat, swallow food, or even to speak
- The treatment of choice is a surgical excision with clear margins followed by radiation therapy or chemotherapy, as decided by the healthcare provider. In majority of the cases, the prognosis is good with appropriate treatment
- Nevertheless, the prognosis of Squamous Cell Carcinoma of Oral Cavity depends upon many factors including the stage of the tumor and health status of the affected individual. There is a possibility of local or regional metastasis, which can involve the lymph nodes. This may dictate the course of the condition
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What Is Mouth Cancer In Cats
Oral cancer accounts for approximately 10% of feline cancer cases and is the third most common site of cancer in cats. Oral cancer leads to the formation of harmful swellings or other lesions within the oral cavity, along the gums, palate , or within the throat. Squamous cell carcinoma is the most common oral cancer in cats.